We can’t say it enough; if you’re thinking about doing a virtual Thanksgiving but not sure if your single action is really going to make a difference— it is going to make a difference. I thank every one of you doing whatever you can do within your means right now. #covid19
2/ People are motivated when they know they aren’t alone— when it’s not only them that is taking one for the team; people need to believe there is a team at all.
There is a team. There are thousands if not more who are going to hold off on Thanksgiving this year.
3/ I will be working in the hospital during this holiday. Know that I am motivated knowing there are so many people out there supporting us. So many people out there who are giving up something huge because they want to help-that motivates me to keep pushing against this epidemic
4/ If there’s anything I’ve learned this year- it’s that we have to support each other; to inspire each other- even when we didn’t have leadership we could count on, we pushed onwards. Let’s keep pushing— we are too close to stop now. Do whatever you can— we will too. #covid19
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*short thread* 1/ Really important study here looking at false negative test results for #covid19 in March-May 2020 at a mediocre hospital in Boston (Mass General 😉)– 60% of these ended up being in samples drawn either “too early” or “too late”
2/ And in the few that clinically seemed like they had #COVID19 but had two negative NP swabs, their lower respiratory tract sample was positive in all of them (as we might expect as disease burden migrates from upper to lower resp tract over time)
3/ Peak false negatives occurred during weeks of peak overall positivity — higher pretest probability, higher chance your negative test in a suspected case was actually a false neg
Overall, only 2.2% of tests classified as false negatives (in which subsequent pos w/in 14 days)
2/ @RanuDhillon & I wrote about an aspect of this back in September; one of the problems is that tracing spread to pinpoint exactly where transmission happened is actually not that straightforward which makes policy making difficult for #covid19
3/ We are left w/ tough choices, but as with everything, inaction has a serious cost
Decisions need to be made via risk (or cost)/benefit— if the possible benefit outweighs the poss cost, then the choice may make sense. For epidemic control, this calculation is key (but complex)
You know that moment when all the water pulls back from the beach until it’s completely & eerily empty right before a huge tsunami hits?
That was how it felt leaving the hospital today. Nearly every patient I took care of was #covid19 positive, up until the end of my shift.
2/ All kinds of stories here— stories that I’ve heard before; stories from April when we had our last surge. People infecting their parents, roommates infecting each other; nursing home/group home patients infecting each other.
3/ We tried to warn everyone to not travel unless it was an emergency & absolutely needed, not because we don’t want you to see your loved ones, but because we don’t want you to have to see them in a hospital bed as we see them. I am genuinely worried about what is coming next.
1/ We usually call family members daily to update them on their loved ones. Some of the toughest calls are when the family is also infected. Many feel like it’s their fault for infecting mom or dad. Not being able to isolate safely at home *is not your fault*. #covid19
2/ Safe isolation is a fundamental part of epidemic response. This was a responsibility of our states & our government to provide this for people. As the virus surges, we will find ourselves in these situations again (we already are to be honest)
3/ I’m going to bring this back to the holiday before us. Please realize that spending days together at home with family you don’t usually see is a very bad idea. Testing helps & its necessary - but it won’t guarantee safety on its own.
A traveler who tested neg 48 hrs prior to flight was infectious by day of flight, pre-symptomatic; using genomic analysis, traced to 4 cases of in-flight transmission
2/ I don’t say that lightly. I know that this is a big sacrifice; but we were just shy of 200,000 new #covid19 cases yesterday. Hospitals will *not* be able to handle a holiday superspreading disaster happening simultaneously around the country.
3/ The problem with prevention is that it is hard to appreciate disasters that we avoided. This has been a challenge since the days of #stayHome - it can feel like a thankless task. But as a healthcare worker, I am thanking you right now. Please.
1/ The single most important lesson I learned working on a state #covid19 response for 7 months: there is nothing worse you can do in an epidemic than waste time
2/ We have an intervention that we know works, that is of immense benefit w/ little to no cost. Yet we are still leaving that up to choice in so many parts of this country.
Don't ask me to say #MaskUp again- we need a national mask mandate for indoor spaces, now.
3/ We have thousands of Americans (maybe more) who are thinking about flying around the country for the holidays.
This is a true catastrophe waiting to happen. This is an epidemic slingshot being stretched, & will fire off more cases than we can handle.